A breath of fresh air for tobacco control

Do smoking bans work? New research into smoking behaviour and European tobacco control measures leaves little doubt that they do. A team of scientists led by the Smoking Control Unit of the Catalan Institute of Oncology (ICO) in Barcelona, Spain, concludes that tighter control...

Do smoking bans work? New research into smoking behaviour and European tobacco control measures leaves little doubt that they do. A team of scientists led by the Smoking Control Unit of the Catalan Institute of Oncology (ICO) in Barcelona, Spain, concludes that tighter controls coincide with curbed tobacco consumption and reduced exposure to second-hand smoke. The team's findings are published in the journal PLoS ONE.

Smoking bans or restrictions are, however, just part of the picture. The study lists a range of powerful policies for tobacco control. These include price hikes, advertising or promotion bans, consumer information and health warnings, and support for smokers striving to kick the habit.

The Tobacco Control Scale (TCS), a tool developed in 2006, measures and monitors the implementation of such control policies in European countries. A high score indicates an intense policy effort, with individual policies weighted for impact. 'It has been demonstrated that increasing the price of tobacco is the most effective measure for controlling smoking (30 points out of 100 on the TCS scale) as compared with other action, such as, treatment to quit smoking (10 points on the TCS),' explains the Head of the ICO, Dr Esteve Fernández Muñoz, who was also a co-author of the study.

To analyse the effectiveness of such measures in the 27 Member States of the EU, ICO researchers joined forces with colleagues in Barcelona, Dublin (Ireland) and Milan (Italy). Together, they correlated TCS information with the outcomes of a Eurobarometer survey on tobacco consumption, a study funded by the European Commission as part of its ongoing exploration of public opinion in the EU.

Key results from the underlying Eurobarometer survey included the following findings: 3 out of 10 Europeans (31.5%) aged 15 and over are smokers, and 13.6% of non-smokers report regular exposure to second-hand smoke at home. Cross-referencing with the TCS scores notably revealed that smoking seems to be somewhat less frequent in countries with higher scores in the TCS (such as Ireland, Malta, Sweden and the United Kingdom), but is more widespread in countries with lower TCS scores. Self-reported exposure to second-hand smoke appears to follow a similar trend.

Dr Fernández Muñoz concludes: 'The countries with the highest score in the TCS apply active control policies and the consumption of tobacco and the proportion of the population exposed to smoke, both at home and in the workplace, is more reduced.'

These insights add weight to new Spanish legislation which introduced tougher bans on smoking in public places from January 2011 - a move that is likely to shore up the New Year's resolutions of many a Spanish smoker. Dr Fernández Muñoz notes that the new law 'is an example of the very important progress in the control of smoking and means the abolition of the "Spanish model" of supposed tolerance'.

While Spain already scores high on the TCS in general, a stricter stance on smoking is expected to help reduce the incidence of cardiovascular disease and cancer. Between 1,200 and 3,200 lives currently lost to lung cancer and heart attacks in Spain every year are thought to be a direct result of passive exposure to smoke.